Sickness, Suffering, and the Sword

by Andrew Bamford

  But even if it is allowed that some losses were inevitable, it is impossible to forget that we are dealing with flesh and blood; the resources that were being consumed were the lives of the men in the ranks. A soldier who fell ill could expect a decidedly uncertain future, particularly at the beginning of the period when the British Army’s hospital arrangements were at their worst. Under such circumstances, it is scarcely surprising that some soldiers, even if they survived the circumstances that led to their hospitalization, took months or even years to return to their units. Others, once detached, contrived never to return at all, and this brings us to the second—and secondary—drain on campaign manpower: desertion. The circumstances leading to an individual’s decision to desert are themselves individual, but Sherer’s identification of suffering as a factor tending toward the reduction in a unit’s strength can certainly be considered as one of them. Hard service could bring on illness that could, in itself, take a man out of the ranks, but it could also break down the interpersonal bonds that held a unit together. Under such circumstances, absenteeism increased as men left the ranks to search for food, or fell out through exhaustion; however, since there was no intermediate category of being absent without leave, it was all too easy for the straggler to become the deserter. In order to minimize losses in this way, effective leadership was needed to keep a unit functioning cohesively through even the hardest service.

  In a sense, it is hardly to be wondered at that some regiments became and remained sickly due to places that the fortunes of war took them. What is more important, so far as we are concerned, is how those varying sickness rates were managed and whether—and for how long—the units in question were able to remain in the field. At a regimental level, strategic consumption is therefore intrinsically linked to the history of a unit’s service and the way in which it was led.

  Health and Sickness

  In the aftermath of the Peninsular War, Sir James McGrigor, inspector of hospitals under Wellington during the second half of the conflict, put his thoughts in order so as to be able to present them to the Medical and Chirurgical Society, of which McGrigor was vice president. Before joining Wellington’s staff in the peninsula, McGrigor had seen extensive service encompassing the Egyptian campaign of 1801 and the Walcheren expedition. If anyone was in a position to speak with authority on the topic of illness amongst soldiers, then it was he. In his short paper, McGrigor gave a précis of the medical aspects of Wellington’s 1812, 1813, and 1814 campaigns, which prefigured a discussion of the key diseases encountered and the means by which they might be better prevented in a future campaign.1 What is particularly significant about McGrigor’s analysis, however, is the amount of times in which a clear focus is made on the particular circumstances of a regiment—or, more common still, a division—as a direct contributor to its state of health. These circumstances could range from being in a particular station to having received a recent influx of recruits, but McGrigor was sure that they made a difference, and had the figures to prove it.

  Losses from sickness, rather than from combat, represented the single greatest drain on British military manpower during the period of this study, with roughly three deaths from the former cause to every one of the latter during the Peninsular War.2 The topic of sickness and mortality amongst troops in active service has accordingly merited much study, going right back to McGrigor’s 1815 paper. However, the range of data obtained during the research for this study enables a far more wide-ranging analysis to be carried out, both in relation to the data of McGrigor and in comparison with more recent historiography. Most notable amongst modern writing is Dr. Martin Howard’s Wellington’s Doctors, which draws heavily from McGrigor’s work but also uses Howard’s own medical training to diagnose more accurately the symptoms experienced by British troops.3 However, Howard’s work makes use of McGrigor’s statistics based on the records kept by the hospitals rather than those kept by the regiments, as here. Thus, whilst Howard is rightly full of praise for McGrigor’s reforms of the peninsular medical services from 1812 onward, he fails to account for the fact that regimental records indicate that the ratio of sick to effective manpower remained poor throughout the last two years of the conflict. As we shall see, this discrepancy between the impression given by the hospital and regimental returns exposes a key failing in the systems of manpower management in the peninsula.

  Before focusing on the specifics, however, it is important to try and obtain some idea of the scale of the question. The number of deaths in the theaters sampled for this study is staggering: some 55,088 in total.4 This sample does not include troops in the eastern Mediterranean, the East and West Indies, or, before 1812, North America; nor does it include troops on the home station. However, by being selective this coverage encapsulates the death rate for the active component of the British Army—a body that averaged some 64,645 men across the period. The greatest proportion of these deaths—41,863 of them, or 76 percent—were in the peninsula, and the majority of them were not combat-related. Although the data, presented in graph form as figure 7, makes no distinction between deaths from battle or from illness, nor between sick and wounded when it comes to men in hospital, this fact is rendered obvious by the slight nature of the increases seen even at the times where heavy fighting was taking place. Waterloo, as the bloodiest battle in absolute terms, makes a significant impact, and the costliest elements of the War of 1812—the Niagara and New Orleans campaigns—also stand out in relation to the usual death rate for those theaters, but even Albuera and Badajoz do not rival the number of deaths seen during the worst epidemics.

  Substantial though these figures are, it is important to recall that the dead did not represent the only cause of loss through sickness, as a great number of men were also sent home unfit for active service, or else discharged from the service altogether. Data for the whole of the British Army is incomplete, but some examples at the regimental level demonstrate the point. The 1/40th began the Peninsular War with a total strength of 909 rank and file; during the course of the conflict, 967 men died whilst serving with the battalion, and a further 411 were sent home between August 1809—the first month for which this data is available—and May 1814. Together, this totals 1,378 men, and yet the battalion still mustered 829 total rank and file when it left the peninsula. Whilst the 1/40th was known as a sickly unit, and was also involved in a fair amount of heavy fighting, it is by no means too extreme an example. The 2/83rd also served throughout the conflict, beginning with 856 effective rank and file and ending with 491. During the war, it lost 626 dead and sent a further 153 men home: 779 in total. Unlike the 1/40th, the 2/83rd could not so readily call on replacement manpower and thus shrank to a lower effective strength, and this largely explains its apparently better survival rate. Whereas the 1/40th was topped up with replacements, some of whom also became casualties, the 2/83rd was allowed to shrink. The veteran core of the 1/40th is unlikely to have been any less healthy than the veterans of the 2/83rd, but the figure for the former unit is inflated by illness amongst the reinforcements. This distinction, in turn, emphasizes McGrigor’s point that those fresh to active service were far more likely to fall ill than seasoned men.5

  Figure 7. Deaths on Active Service, 1808–1815. Data from combined returns, as detailed in appendix 1.

  Whilst losses through death or permanent disability were self-evidently absolute and had to be replaced, the second drain on manpower as a result of sickness and wounds was those men temporarily unfit for duty who remained on the strength of their units, either in regimental hospitals or detached to general hospitals within the theater of war. Working as an average across the period, the figures suggest that around a quarter of all active manpower was rendered ineffective at any one time through sickness or wounds. Again, the vast majority of these men were from the forces in the peninsula. It is true that for the bulk of the period these forces represented by far the largest concentration of troops, but, even so, the proportion of ineffective troops in the peninsula is g
enerally greater than for forces of equivalent size in Flanders in 1815 or, even, on Walcheren in 1809. However, although the peninsular figures do remain high throughout, it is worth noting that they peak in late 1812 and that thereafter the number being returned as sick declines even though, at the same time, Wellington’s army was growing in size. Thus, in proportional terms, the sickness rate fell far more steeply than the absolute figures would suggest.

  Table 9. Sickness and Death Rates by Theater

  Source: Sources as per appendix 1. “Northern Europe” covers Germany, Flanders, and France, 1813–15.

  Considering sickness rates in proportional, rather than absolute, terms also helps clarify the situation with regard to the other stations to which the British Army was deployed. Table 9 ranks the main theaters of war in terms of their average sickness rate across the period, giving in addition the average number of deaths per thousand men. With the data presented in this way, it becomes clear that although the peninsula was exceeded only by Walcheren in terms of the levels of sickness amongst troops deployed there, the death rate was nowhere near as high. Comparing like with like, sickness levels tend to be higher in the warmer theaters, due in no small part to the greater prevalence of fevers. Figures for Cadiz and Gibraltar are higher than those for other garrison commands due to the prevalence of yellow fever in southern Spain, and, epidemics aside, the base rate for sickness and deaths was far lower; of the 1,494 deaths recorded at Gibraltar between 1808 and 1815, 362 of them were concentrated in the last four months of 1813 when there was yellow fever on the Rock.6 Extreme cold could also pose problems, and in Canada care needed to be taken against the outbreak of contagious disease amongst troops in winter quarters.7 To a lesser extent, contagion whilst in winter quarters was also a problem in the peninsula, whilst exposure to cold was in itself also an issue, as was also the case in Holland during Graham’s campaign and—most memorably—during Moore’s disastrous winter campaign in Spain. On the other hand, although the coastal United States contained unhealthy areas, particularly in the swamps around the Mississippi delta, the high incidence of both hospitalization and death there has far more to do with American bullets than American pathogens.8

  As well as showing marked distinctions between different theaters of war, sickness levels also show marked distinctions between the various arms and subdivisions of the service, and between British troops and foreign units in British pay. Infantrymen were nearly twice as likely to be hospitalized than cavalrymen, and more than twice as likely as artillerymen. Specialist garrison and veteran units have a particularly low sickness rate, as do the Canadian provincial regiments in the War of 1812, but this is readily understandable, since these units saw little active campaigning. On the other hand, the deviation between British and foreign infantry, which also recurs in the cavalry, albeit to a lesser extent, is less readily explained. Although many of the foreign units served in secondary theaters, and in general saw less combat, this can only serve as a partial explanation for their lower levels of sickness. However, much of the foreign manpower taken into British service represented men who had already seen service in other armies, and who were accordingly better acclimatized to service. McGrigor believed that “The temperance, steadiness, and regular habits of the German legion, kept them always in a state of health.”9 These qualities speak of experience, and McGrigor’s assertion is further supported by the statistical data at a regimental level. Discounting small detachments, the worst average sickness ratio in a KGL unit is that of the 5th Line Battalion, averaging 20.6 percent over eighty-one months of service in the peninsula and northern Europe; by contrast, no less than fifty-six equivalent British units have worse ratios, with the worst having twice as many men on average sick than the KGL battalion.

  Since the distinction between British and KGL sickness rates can be positively identified and attributed, at least in part, to better training and leadership, it is perhaps all the more surprising that a similar distinction cannot be made within British units. There is no obvious division between units that were notable for being either poorly or expertly commanded, nor for those that might be expected to have a strong unit identity or esprit de corps. Indeed, the two most sickly battalions—the 68th and 1/23rd—might both have maintained a claim to elite status, the one as light infantry and the other as fusiliers. One explanation for this might be found in the tendency, discussed in chapter 2, for elite units to incur heavy battlefield casualties during the course of maintaining their self-defined status, but it seems unlikely that this is the whole story. Nor does it seem sufficient to simply assert, irrespective of unit, that that the majority of British officers had little care for the well-being of their men, since there is substantial evidence to the contrary—not least the fact that many units, even in unhealthy theaters, were able to maintain a decent level of fitness.10 Negligent officers certainly did exist, and are encountered in these pages, but it is absurd to suggest that they represented the norm. Many, it is true, could have learned from their colleagues in the KGL, but this is evidence of inexperience, not of neglect. It certainly is the case that some units known to have had bad commanders do have particularly poor sickness ratios—26.4 percent in the 2nd Foot, for example—but if inadequate leadership did contribute to higher levels of sickness, it is clear from the even poorer ratios found in well-led units like the 1/23rd that it was only a secondary factor.

  Rather than try and attribute effectiveness to the qualities of individual units and their commanders, we need instead to look at the nature of the service undertaken by those units, for, as the data in table 9 suggests, it is here that the distinctions become more apparent. The main recurring factor that pushed sickness levels up at a unit level was service with one or both of the two most unhealthy commands: the Walcheren expedition or the peninsular field army. It is therefore to these two theaters, and the very different circumstances surrounding them, that we must turn our attention.

  Having the highest rate of both sickness and deaths, but seeing only limited fighting of low intensity, Walcheren and its surrounding islands by far and away constituted the unhealthiest European theater of war. During the Walcheren expedition, 2,041 men died of disease and a further 1,859 after the return home, in contrast to 99 deaths through combat.11 The cause of this disaster is, now, obvious enough—the island was a malarial swamp, although additional symptoms, including loss of appetite and an enlarged spleen, suggest that complications were involved12—but there are a number of important issues surrounding the campaign that have a wider impact on this study. Most obviously, the scandal resulting from the number of deaths accelerated the reform of the British Army’s medical services, and indirectly led to the reforms eventually implemented in the peninsula under the aegis of McGrigor and others.13 However, the story is by no means one-dimensional, and had its beginnings months before the expedition was even conceived. It was widely recognized at the time that men who had served on Walcheren and had been exposed to its fevers were prone to relapse, and that units that had served there were accordingly prone to develop high levels of sickness when subsequent active service rendered men’s constitutions vulnerable. But whilst the future service of the Walcheren regiments forms one part of the story, it is also necessary to look at their prior careers, since in a great many cases service on Walcheren was not, in itself, uniquely devastating but, rather, represented a final straw that broke individuals—and units—that were already weakened.

  This second point may seem illogical, but makes sense when one considers that the majority of the units that formed the Walcheren expedition had recently returned from the first peninsular campaign culminating in Moore’s retreat to Corunna. It is therefore necessary to question the extent to which this arduous and extreme service had already rendered the units involved unfit and thus susceptible to further disease. As well as the effects of cold, hunger, and exertion, many of Moore’s regiments had contracted typhus from their Spanish allies, and there had also been an outbreak of ophthalmia, render
ing many men temporarily blind.14 Even those men who finished the march without succumbing to illness were weakened by malnutrition and exhaustion. Furthermore, the survivors returned to Britain in an awful condition with men landing in odd lots at different ports, some being retained in hospitals whilst others marched to their depots. This inevitably led to confusion as units began to reassemble, and delayed the recovery of those men who found themselves detached from their units. In the 2/59th, for example, 314 men were listed as missing in February 1809 from a rank-and-file strength of 728, though the unit’s total losses on campaign had amounted to only 143. This figure, furthermore, did not take into account an additional 176 men sick in hospitals, leaving only 233 rank and file fit and present for duty and causing the unit’s commander to bemoan the inaccuracies in the “supposed list of the missing.”15 The situation for the 2/59th was typical of most of Moore’s battalions, and in many cases the sickness figures remained high well into 1809 as detailed in appendix 2.